NPI | 1568923423 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: MI 4301514942) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 78760) |
Enumeration Date | 2019-03-25 |
Last Update Date | 2025-09-04 |